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mum <br /> SIGN PERMIT APPLICATIO <br /> EVERETT SUBMITTAL CITY OF EVERETT PERMIT SERVICES <br /> INSTRUCTIONS:Drop off hard copy paper application&plans to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> WASHINGTON CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: Li(')I STREET) 5L1J -- /,‘` Why PARCEL#: bC) I'{oLno f�(S 0 <br /> CnY O V4�Q S -- STATE tvI 21 <br /> ZIP <br /> SUITE/UNIT#: ADDITION L LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): ti E7vc9•} AvA <br /> CONTACT INFORMATIONIECEIRVE-3 <br /> OWNER NAME: () cs.a L L APR 14 2022 <br /> OWNER MAILING ADDRESS: sTREET k S C) -. C�t-v�t,/U Q -4c. 00/ 5 CITY OF EVERETT <br /> CITY A/v ;12- ) STATE �4 Permit S€rr it I <br /> OWNER PHONE: S`'`C� 7 , (� Oa OWNER OWNER EMAIL: <br /> CONTRACTOR CONTACT NAME: -6 f_C() ) ` l 6 A X1e.-hLa C✓i�j�n s' <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):f4pVAA/12-q aiw CI OF EVERETT BUSINESS LICENSE#(REQUIRED): 5390 I <br /> CONTRACTOR ADDRESS: STREET ) ?7-4-1-" 4,r /U `I,vC <br /> cr Y ( I.YJ i1..t N STATE . ZIP ! (jV ) <br /> CONTRACTOR PHONE:,Z1 -1"g 7- e) 9 'CONTRACTOR EMAIL: ASG, t s-a' ;�-� v►, AJ L. C ci v14 <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: S C an,,Ev RC,rC.5,(-s <br /> f L) C�� CONTACT EMAIL: <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK: $ C, , 0 0 0 ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> DESCRIPTION OF WORK:.rNS ' ,�,1 <br /> G A�`c�S <br /> SIGN DIMENSIONS: ' <br /> Sign 1: Width: i•S I, Height: 7_I • 1 6 i Square Feet: 2-1 <br /> Sign 2: Width • S`-q`` Height: 7 4 • 0)G l' Square Feet: Q_c r LI <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: ❑Wall/Awning/Canopy-Qty: ❑Window-Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting-Qty: ,freestanding-Qty: -Type(monument,etc.):L_ k too A; <br /> SIGN LIGHTING: ONon-liuminated ll inated-Type(backlit cabinet,etc.): *requires a separate electrical permit <br /> PLAN REVIEW REQUIREMENTS: Submit 2 hard copies of sign plans with permit application to Permit Intake Drop Box. <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.1 am the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# S 9-7.-®4 -DOS <br /> Own r/Authorised Agent Signature Date (Revised 2/8/2021) <br /> �/� <br />